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CHOLESTEROL… WHAT’S TO FEAR?

Bon Appetite!
Have you ever been about to take a big bite of your triple chocolate fudge cake when someone leaned over and said: “you had better watch your cholesterol”? And did you notice the earnestly anxious physiognomy of that young lady who started admonishing you against eating the very meal that just an instant ago made your mouth water and your stomach melt in anticipation? No matter how hungry and excited about the meal you may be, the vehement rant against cholesterol always seriously affects your appetite… So, is the lady right or is she simply misinformed and overly obsessed with ridiculous diets?

Cholesterolphobia
This article is intended to analyze an unrecognized, yet a pandemic phobia and, for a noble psychological purpose, to try to eradicate or, at least, assuage it. In order to achieve this, as in the case of more familiar phobias, it is vital to trace back its origins, to convince those afflicted that it is indeed both unreasonable and detrimental, and to amiably “serve” the result to a newly whetted appetite.

The target to be annihilated is “Cholesterolphobia”. Although this is not an accepted technical term, I can justify my coining it by the many perfect similarities with the general definition of the word “phobia”. First of all it represents an irrational fear, as the further arguments will tend to prove. Secondly, nowadays it has become almost omnipresent and very persistent. And, last but definitely not least, it has grown into a real plague, as it consumes people’s money, wastes their time, and erodes their precious, irrecoverable nerves. A pivotal point to specify is that “cholesterolphobia” is essentially different from anorexia, since its cause represents not so much the concern for a robust and statuesque figure, needless to mention any other reasonable concern for health, but rather a literal groundless aversion to the substance called “cholesterol”.

Most people nowadays hear the word “cholesterol” in a context of severe admonitions “reinforced” with esoteric scientific terms and principles that impress many, in spite of being confusing and fallacious. The notion “cholesterol” is usually served by the Mass Media and the countless bogus nutritional and dietary magazines in such an abusively spicy dressing that it really starts to burn the palate of people’s minds and shatters their appetite for anything that reminds them of this. Thanks to the Mass Media, which has done a great job disseminating the specious message of the imposing leading pharmaceutical companies of the world, “cholesterol” has definitely earned its place in the “top scary” list of the “Horror” encyclopedia among words like bogeyman, hydra, harpy, and chupakabra. The word “cholesterol” might soon be used by parents to scare teenagers just as efficiently as the word “caries” works with the naughty little chocolate-devouring kids who still remember their last appointment with the dentist. For instance, a mother could “persuade” her dear teenage-rebel to comply with the diet offered and give up chocolate, ice-cream, and various snacks with a statement like: “If you don’t do as I say, cholesterol will insidiously pervade your whole body, clogging up all your blood vessels one by one until, one day, you succumb to heart attack or stroke!” This sounds pretty convincing, doesn’t it?

Seriously speaking, many people really display an unwarranted tendency to believe that cholesterol is a particularly pernicious substance comparable in its toxicity to snake venom or any other deadly poison, which is a lamentable fallacy… Unfortunately the numerous schoolbooks of biology and, especially the countless nutrition brochures and diet leaflets never provide even rudimentary scientific information on this issue. Nevertheless, it is enough to open the simplest book on molecular biology for beginners in order to find the “real story” about cholesterol and dissipate any doubt about its functional importance…

What is cholesterol?
Cholesterol is a waxy, fat-like compound that belongs to a class of molecules called steroids. Despite the notoriety it has earned through the many widespread misconceptions, it is important to mention that cholesterol is ubiquitous in the human body, being found in the structure of all the cells, particularly those of the nervous system and of some glands, as well as in the blood and lymphatic circulatory systems. Cholesterol is essential inasmuch as it:

  • is an indispensable structural element of absolutely all the biological membranes found in animal cells, conferring relative rigidity to the lipid bilayer of the membranes. If it weren’t for cholesterol, the membranes would be extremely delicate and would disintegrate easily, making the cells excessively vulnerable, and causing their death at the slightest pressure;
  • constitutes the only raw material for the synthesis of sex hormones (testosterone, progesterone, estradiol), and corticosteroids (aldosterone, cortisol…), which are some of the main biological regulators of the animal body;
  • is converted into vitamin D in the skin when exposed to sunlight (more specifically – to the ultraviolet rays of the sunlight). Deficiency of vitamin D impairs the body’s ability to absorb calcium and leads to bone degeneration and severe skeleton deformation in a disease called rickets;
  • is also the precursor molecule for the synthesis of bile acids, which are stored in the gall bladder and secreted into the small intestine in order to emulsify the fats contained in foodstuffs, thus promoting digestion by the pancreatic enzymes;

Due to strict necessity for cholesterol, it is naturally synthesized in our bodies all the time. It is produced primarily in the liver, but also by cells lining the small intestine and by individual cells in the body, summing up to about 1 gram per day. Our body also obtains cholesterol from the food we consume. And here comes the fact that eloquently demonstrates how exaggerated the fuss about cholesterol is: as a matter of fact, people normally take in up to 0.25g, though most consume much less, and even the most gluttonous greasy-food-junkie can hardly go up to about 0.4g. Thus, the quantity of cholesterol we get from food usually constitutes up to one-fourth, and can never reach even one half of the amount of cholesterol that our own body produces. The latter can’t be called into question since, first of all, as we all know, very greasy food causes nausea and leads inevitably to vomiting, which is a natural protective mechanism triggered by the insufficiency of bile and the resulting incapacity to digest. Besides, even if both the liver and the pancreas turned on some extra super generator due to “fat alert”, we just wouldn’t be able to stuff that much food into our stomachs!

Then there comes another argument against cholesterolphobia. It is the fact that the human body has the ability to gradually adapt to any kind of changes, especially when it comes to a simple reduction in its activity. Its physiological regulation is similar to the free market economy, in this case, tending to adjust the supply and demand of cholesterol. Thus, when more cholesterol is obtained from food while the physiological demand stays the same, the liver simply spares its own forces by reducing the amount of internal production. This adjustment is adequately coordinated in a healthy person, so that a little extra cholesterol should, in no circumstances, be taken as seriously as many people do nowadays. Besides, even if the liver still keeps producing cholesterol at approximately the same rate, normally the body will activate the disposal mechanism and eliminate the excess in order to maintain homeostasis.

Yet another momentous thing to mention is that, in fact, the cholesterol contained in food is not necessarily absorbed integrally! There is a difference between dietary cholesterol (the cholesterol you consume) and serum cholesterol (the cholesterol in your bloodstream). Dietary cholesterol is present in varying amounts in some food of animal origin, such as meat, poultry, seafood, eggs, and dairy products. However, dietary cholesterol does not necessarily become blood cholesterol when you eat it. Actually, it’s possible for some people to eat foods high in cholesterol and still have low blood cholesterol levels. Likewise, it’s possible to eat foods low in cholesterol and have a high blood cholesterol level. It all depends on the ability of the body to regulate its own internal environment!

Why is there so much talk about cholesterol in our diet?
The simple answer is that the increase in dietary cholesterol has been associated with atherosclerosis, the build-up of plaques that can narrow or block blood vessels. If the coronary arteries of the heart become clogged, a heart attack may occur. The blocked artery can also develop rough edges. This causes plaques to break off and travel, obstructing blood vessels elsewhere in the body. A blocked blood vessel in the brain can trigger a stroke.

“Good” cholesterol vs. “bad” cholesterol?
Cholesterol is not soluble in water. Therefore, it cannot dissolve in the blood serum either, as the latter is a watery medium. That’s why cholesterol combines with certain apoproteins, which are special water-soluble carrier proteins that act like trucks, picking it up and transporting it throughout the body. Thus, complex compounds called lipoproteins are formed. Their density is determined by the amount of protein in the molecule. The two most important types of lipoproteins are: high-density lipoproteins (HDL) and low-density lipoproteins (LDL). So, actually, the term “bad cholesterol” is attributed to the low-density lipoprotein (LDL), the major cholesterol carrier in the blood. High levels of LDL are most likely to contribute to the clogging of blood vessels, keeping blood from flowing through the body the way it should, and are thus usually associated with atherosclerosis. “Good cholesterol”, on the other hand, is the label given to high-density lipoprotein (HDL), which, in simple terms, can be compared to the drain cleaner people put in the sink in order to provide some protection against artery blockage.

After a cell has used the cholesterol for its chemical needs and doesn’t need any more, it reduces its number of receptors for LDL. This makes LDL accumulate in the blood. If the body does not handle this problem promptly and properly, then the LDLs begin to discard and deposit cholesterol on artery walls, forming thick plaques. In contrast, the HDLs – “the good guys” – act to remove this excess cholesterol and transport it to the liver for disposal.

Not only does there exist a considerable difference between the amount of dietary cholesterol and the level of serum cholesterol, but also “blood cholesterol” is a rather inappropriate term. The “serum cholesterol” level is, in fact, represented by the total amount of lipoproteins, but not by actual free cholesterol, which, as mentioned previously, is not water-soluble. However, the plaque consists mainly of the pure cholesterol freed from the LDL molecules due to the very fact that cholesterol, once freed, can no longer travel through the plasma normally and precipitates on the walls of the blood vessels. Thus, a high concentration of LDL in the blood does not inevitably lead to plaque formation. The fact that many people munch popcorn and snacks at the cinema does not necessarily mean that there will be huge filthy piles of litter in the movie theater in the end, does it? In a “wholesome” society, most people have the propriety to take the rubbish to the closest trashcan. Likewise, in a healthy body, the lipoproteins take the cholesterol to its destination point, without simply discarding it randomly throughout the circulatory system!

Contrary to public opinion, the key phrase when referring to the cause of atherosclerosis should be “healthy body”, but not “wholesome diet”. As a matter of fact, many recent research results, the accuracy of which has not been affected by any of the highly influential pharmaceutical producers of blood-cholesterol-lowering drugs, show that cholesterol level is not appreciably influenced by diet. So, instead of completely eliminating many highly nutritional alimentary products from their diets just because these contain cholesterol, people had better try to improve their way of life through regular physical exercise, systematic walks, and maintaining a natural general state of well being.

What causes an elevated level of cholesterol?
There are certain intrinsic factors that physiologically influence the cholesterol level in the blood.
Age: The blood levels of cholesterol tend to increase as we get older. Old age, as we all know, brings health problems and causes general debilitation of the body due to the gradual loss of many vital functions and the disturbance of many physiological processes.
Genetics: Due to the genetically engendered over- or under-stimulation of certain enzymatic pathways, congenital diseases related to lipid regulation occur in many people. Unfortunately, this problem cannot be efficiently remedied or totally eliminated by modern medicine.
Disease: Certain maladies can affect some of the many previously mentioned functions related to cholesterol level control. In yet more cases, it is the medication prescribed for the treatment of particular illnesses that causes cholesterol disbalance.
Gender: Statistics shows that men aged up to 50 tend to have a slightly higher cholesterol level than their female peers. However, after 50, when women are in their post-menopausal years, decreasing amounts of estrogen are believed to cause cholesterol level disbalance.
Weight: It is usually stated that corpulent people are more likely to have high blood cholesterol levels than the slim ones. This is generally true. However, obesity is a symptom that comes in tandem with excessive blood cholesterol rather than a cause for the latter. The actual reason is a physiological problem (either genetic or acquired as a result of some condition) with lipid transport and disposal.

There are also variable extrinsic factors that can, in some way, influence the cholesterol level.
Psychological state: Serum cholesterol level can vary depending on the usual psychological state of a person. The two stress-related hormones – cortisol (associated with long-term stress) and adrenalin (associated with high-intensity short-term stress and shock) – considerably affect the bodily biochemistry. Research results indicate that excessively high levels of cortisol impair the intake of cholesterol, which, consequently, accumulates in the blood vessels.
Lifestyle: It is a well-known fact that moderate physical exercise has lots of beneficial effects on the body, including the stimulation of blood circulation and cholesterol balance maintenance. On the other hand, smoking can dramatically disturb that balance and cause various related problems.

Research results on Cholesterol-Heart Disease
The fact that dietary intake of cholesterol has no impact on the level of cholesterol in the blood is obviously illustrated, for instance, by two of the major long-term studies, Framingham and Tecumseh. These show that those who ate the most cholesterol had exactly the same level of cholesterol in their blood as those who ate the least cholesterol. This is hardly news. Ancel Keys, the man, who, more than any other, is responsible for the creation of the diet heart hypothesis fully agrees. This is what he wrote:
"There's no connection whatsoever between cholesterol in food and cholesterol in blood. And we've known that all along. Cholesterol in the diet doesn't matter at all unless you happen to be a chicken or a rabbit." - Ancel Keys, PhD, professor emeritus at the University of Minnesota 1997.

But, even after their first hypothesis was incontrovertibly refuted, the cholesterol-lowering-diet proponents quickly put forth another one: “It is not cholesterol in the diet that causes the cholesterol level to rise, it is the consumption of saturated fat”. However, this one proved to be even more tenuous, and was soon crushed too. There was prompt feedback again, this time stating that: “It’s not saturated fat in the diet, it’s the ratio of polyunsaturated to saturated fat ratio…” And this really reminds me of the funny situation in which a desperate truant kid keeps concocting one lame excuse after another right before the vexed teacher’s eyes.

Uffer Ravnskov, a Finnish medical practitioner, has demonstrated just how the establishment maintains orthodoxy in defiance of overwhelming contrary evidence. He looks at all the evidence, not just the papers favored by the establishment, and disposes of the myths one by one.

The easiest way to keep the established theory popular is, of course, by concealing, or, at least, ignoring any facts that are inconvenient. The sheer brass neck with which authors select their data is truly astonishing. Ravnskov cites several cases where the summary of a paper is at variance with its content. Subsequent authors, of course, only look at the summary or, more often, an account of it by someone else. Ravnskov describes a typical case, in which two papers giving the results of trials were published in the same journal. The one whose results did not support the orthodoxy received 15 citations over the next four years. The one favoring the orthodoxy, however, received 612 citations in the same period.

These are just some of the many methods used to prop up the myths that have provided the foundation for huge industries, the cholesterol one being worth billions of dollars. They enable academics to earn reputations, establish large departments, and win prizes, all this being done with minimal mental exertion. Nevertheless, fortunately, there still are a few “little boys who are prepared to point out that the king has no clothes!” Healthy diets are advisable, but not to be transformed into a ludicrous, deleterious obsession. And they should be really healthy, because excluding vital types of food from one’s diet, fasting, and starving can by no means be considered “healthy”. And, while there really are reasons why we should limit the amount of certain criticized products, the actual reason is usually related to the cooking method, not its natural composition. In this respect, we had better go back in history and listen to what Mark Twain says:
Part of the secret of success in life is to eat what you like, and let the food fight it out inside you.

Denis Dilion

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